VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1651173
Sex: F
Age:
State:

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: cough; congestion; runny nose; sore throat; swollen lymph nodes; chills; fatigue; fever; This is a spontaneous report from a non-contactable consumer, the patient. A 54-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, lot number: unknown) via an unspecified route of administration in the left arm on 19Apr2021 at 15:15 (at the age of 54-year-old) as a single dose for COVID-19 immunisation. The patient did not have any relevant medical history. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications included bupropion hydrochloride (WELLBUTRIN), fluoxetine hydrochloride (PROZAC) and multivitamin (MANUFACTURER UNKNOWN) all for unknown indications on unknown dates and unknown if ongoing. The patient previously received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, lot number: unknown) via an unspecified route of administration in the left arm on 29Mar2021 at 15:15 (at the age of 54-year-old) as a single dose for COVID-19 immunisation. On 19Apr2021, on day 1, the patient experienced chills, fatigue and fever. On day 2, the patient still had fatigue. On 21Apr2021, on day 3, the patient experienced cough, congestion, runny nose, sore throat, swollen lymph nodes, fatigue. Days 5-7, the patient continued to have congestion and runny nose. The events resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures for the reported events included treatment with albuterol and TESSALON PERLES. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events chills, fatigue, fever, cough, congestion, runny nose, sore throat and swollen lymph nodes were resolving at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds: WELLBUTRIN; PROZAC

Current Illness:

ID: 1651174
Sex: F
Age:
State:

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Nausea; Dry heaving; This is a spontaneous report from a contactable consumer, the patient. A 28-year-old non-pregnant female patient received unknown dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 27Apr2021 (at the age of 28-year-old) as a single dose for COVID-19 immunisation. Medical history included fruit allergy (avocado). Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. Concomitant medications were not reported. On 28Apr2021, the patient experienced nausea and dry heaving. The events did not result in a visit to the doctors or other healthcare professional office/clinic visit, and emergency room/department or urgent care. Therapeutic measures were not taken as a result of the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the events nausea and dry heaving was not recovered at the time of this report. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1651175
Sex: F
Age:
State:

Vax Date: 04/18/2021
Onset Date: 04/23/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: shingles; This is a spontaneous report from a non-contactable consumer, the patient. A 32-year-old female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 18Apr2021 (at the age of 32-years-old) as a single dose for COVID-19 immunisation. The patient had no medical history. The patient did not have any allergies to medications, food or other products. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not take any medication within two weeks of vaccination. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 23Apr2021, about a week after the first dose, the patient developed shingles. The event resulted in doctor or other healthcare professional office/clinic visit. Therapeutic measures were taken as a result of shingles and included treatment with Valtrex. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event shingles was not recovered at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1651176
Sex: M
Age:
State:

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data: Test Name: SARS-CoV-2 test; Result Unstructured Data: Test Result:UNKNOWN; Comments: nasal swab

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tinnitus; This is a spontaneous report from a non-contactable consumer, the patient. A 40-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration in the right arm on 26Apr2021 (at the age of 40-years-old) as a single dose for COVID-19 immunisation. Medical history was not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. Concomitant medications were not reported. On 27Apr2021, the patient experienced tinnitus. The event did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. No therapeutic measures were taken as a result of the reported event. Since the vaccination, the patient had been tested for COVID-19. On an unknown date, the patient gave nasal swab for SARS-CoV-2 test and the result was unknown. The clinical outcome of the event tinnitus was not recovered at the time of this report. No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1651177
Sex: F
Age:
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: My wife has had a lifelong struggle with seasonal After the second does her allergy completely went away for the first time in her life; At the time of second vaccination, the patient was at gestation period of 32 weeks; This is a spontaneous report from a contactable consumer. This is the second of two reports. A 34-year-old pregnant female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection, Lot Number: UNKNOWN) via an unspecified route of administration in the arm right on 31Mar2021 at 14:00 (at the age of 34-year-old) as a single dose for COVID-19 immunisation. Medical history included seasonal allergy (reported as "lifelong struggle with seasonal allergy"), COVID-19 and pregnancy (Gestation period: 32 weeks). The patient's Last menstrual period (LMP) was 16Sep2019. The patient had earlier received first dose of (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unknown date (at the age of 34-year-old) as a single dose for COVID-19 immunisation (maternal drug exposure). Prior to the vaccination, the patient was diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 31Mar2021 At the time of second vaccination, the patient was at gestation period of 32 weeks. On 30Apr2021 at 15:00 after having second dose of vaccination, the patient's lifelong struggle with seasonal allergy completely went away for the first time in her life she started doing gardening with in April that was a miracle. Patient struggled with severe allergies. It was reported that would be where she would have a call in sick because her eyes would be happy and asthmatic since the second COVID-19 shot no allergies pollen allergies are no more. The adverse events did not result in a visit to the doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. The patient did not receive any treatment for the events. The events were non-serious. The clinical outcome of the allergy completely went away for the first time in her life was recovered with sequelae and Maternal Exposure During Pregnancy, third trimester was unknown. Follow-up (05Aug2021): This follow-up is being submitted to notify that the lot/batch number is not available despite the follow-up attempts made. Follow-up attempts completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1651178
Sex: F
Age:
State: NJ

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Received vaccine while pregnant; Mild soreness at injection site; This is a spontaneous report from a contactable nurse (patient, self-reporting). A 31-year-old pregnant female patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8736) via an unspecified route of administration in the left arm on 04May2021 at 16:45 (at the age of 31-year-old) as a single dose for COVID-19 immunisation. Patient has no medical and past drug history. Concomitant medications included pre-natal and acetylsalicylic acid (BABY ASPIRIN) from unknown dates for unknown indication. The patient was in her eighteen weeks of gestation period at the time of vaccination. Delivery date was provided as 28Sep2021. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 04May2021 the patient experienced mild soreness at injection site. No treatment was received. The clinical outcome of the event mild soreness at injection site was not recovered and the event Received vaccine while pregnant was unknown at the time of this report.

Other Meds: BABY ASPIRIN

Current Illness:

ID: 1651179
Sex: F
Age:
State: CO

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210504; Test Name: body temperature; Result Unstructured Data: Test Result:101.3 from 10 am to 4 pm; Test Date: 20210504; Test Name: body temperature; Result Unstructured Data: Test Result:101.0 from 4 pm to 8 pm

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever; chills; muscle ache; Fatigue; Difficulty communicating; This is a spontaneous report from a contactable consumer, the patient. A 47-year-old non-pregnant female patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0173) via an unspecified route of administration in the left arm on 03May2021 at 16:30 (at the age of 47-years-old) as a single dose for COVID-19 immunisation. Medical history was reported as none. The patient did not receive any concomitant medications within two weeks of vaccination. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER9729) via an unspecified route of administration in the left arm on 05Apr2021 at 09:30 (at the age of 47-years-old) as single dose for COVID-19 immunisation. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. On 04May2021 at 10:00, the patient experienced fever (101.3 from 10 am to 4 pm, 101.0 from 4 pm to 8 pm), chills, muscle ache, fatigue and difficulty communicating. Therapeutic measures were taken as a result of the events and included treatment with ibuprofen, 500mg, oral, two doses. The adverse events didn't result in doctor or other healthcare professional office/clinic visit, or emergency room/department or urgent care. The clinical outcome of the events fever (101.3 from 10 am to 4 pm, 101.0 from 4 pm to 8 pm), chills, muscle ache, fatigue and difficulty communicating were recovered on an unknown date in May2021. No follow-up attempts are needed. No further information is expected. Amendment: This follow-up report is being submitted to amend previously reported information: added medical history as none, event difficulty communicating updated as communication disorder.

Other Meds:

Current Illness:

ID: 1651180
Sex: F
Age:
State: PA

Vax Date: 04/11/2021
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: a delay in my period; This is a spontaneous report from a contactable consumer, the patient. A 39-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ep1533) via an unspecified route of administration in the arm right on 11Apr2021 at 11:00 (at the age of 39-year-old) as a single dose for COVID-19 immunisation. The patient previously took BONADOXINA. Concomitant medications were not reported. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On unknown date after first dose, patient experienced delayed period. Therapeutic measures were unknown as a result of the event. The clinical outcome of event delayed period was unknown at the time of this report. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1651181
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Arm numbness/Arm and neck still sore and numb/Left foot was numb; Left neck pain; Arm and neck still sore and numb; This is a spontaneous report from a contactable consumer or other non-HCP (Patient). A female of an unspecified age was received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: not reported), via an unspecified route of administration on 15Jan2021 as dose number unknown, single for covid-19 immunisation. Medical history and concomitant medications were not reported. On an unspecified date, the patient experienced arm numbness, left neck pain and left foot was numb. Arm and neck still sore and numb. Now it is intermittent and even if I am standing my left foot goes numb. Question asked Creating this report transmit the AE details" caller states she has spoken to the authorities in regards to the side effects 6 hours arm numbness, left neck pain and left foot was numb. Arm and neck still sore and numb. Now it is intermittent and even if I am standing my left foot goes numb. Outcome of the events was not recovered. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1651182
Sex: F
Age:
State: IA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210331; Test Name: Low fever; Result Unstructured Data: Test Result:Low

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fatague; Soreness at injection sight; Low fever; Swelling of lips, tongue; Tightness in throat; Body rashes; Dizziness; Swelling of lips, tongue; This is a spontaneous report from a contactable consumer (patient). A 67-years-old non-pregnant female patient received bnt162b2 (Solution, injection; Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Left on 30Mar2021 at 18:30 (at the age of 67-years-old) as dose number unknown, single dose for covid-19 immunization. Medical history included lactose intolerance. Patient was diagnosed with covid prior to vaccination. There were no concomitant medications. Patient did not receive any other vaccine in 4 weeks. On 31Mar2021, patient experienced fatague, soreness at injection sight, low fever, swelling of lips, tongue, tightness in throat, body rashes and dizziness. Therapeutic measures were taken as a result of fatague, soreness at injection sight, low fever, swelling of lips, tongue, tightness in throat, body rashes and dizziness and patient was treated with steroid. Lab test includes was Low fever on 31Mar2021. The outcome of the events was not recovered. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1651183
Sex: M
Age:
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Administered 0.5 mL of vaccine, not 0.3 mL; This is a spontaneous report from a contactable healthcare professional. A 23-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0162), intramuscularly in the left arm on 08Apr2021 (at the age of 23-years-old) as a 0.5 ml single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 08Apr2021, the patient was administered 0.5 ml of BNT162b2 vaccine, not instead of 0.3 ml. No therapeutic measures were taken as a result of the event. The clinical outcome of the event was unknown. No follow-up attempts are needed. No further information is expected. Amendment: This follow-up report is being submitted to amend previously reported information: reaction data (updated event to overdose), treatment (NO), and outcome (UNKNOWN).

Other Meds:

Current Illness:

ID: 1651184
Sex: M
Age:
State: NY

Vax Date: 02/26/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Test Date: 202102; Test Name: hemoglobin; Result Unstructured Data: Test Result:drop; Test Date: 202102; Test Name: red blood cell counts; Result Unstructured Data: Test Result:drop; Test Date: 202102; Test Name: white blood cell; Result Unstructured Data: Test Result:drop

Allergies:

Symptom List: Rash, Urticaria

Symptoms: DROP IN HEMOGLOBIN; DROP IN HEMOGLOBIN AND WHITE AND RED BLOOD CELL COUNTS; DROP IN HEMOGLOBIN AND WHITE AND RED BLOOD CELL COUNTS; This is a spontaneous report from a contactable consumer, the patient. A 53-year-old male patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot Number: EN6202), via an unspecified route of administration in left arm on 26Feb2021 at 15:00 (at the age of 53-year-old) at single dose for COVID-19 immunisation. Medical history included Crohn's. Prior to the vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any concomitant medications. The patient did not receive any other vaccines within four weeks prior to the vaccination. On an unknown date in Feb2021, the patient experienced drop in hemoglobin, white blood cell and red blood cell counts. The events resulted in doctor or other healthcare professional office/clinic visit. Since the vaccination, the patient had not been tested for COVID-19. Therapeutic measures were taken as a result of the reported events included iron infusion. The clinical outcome of the events was recovering. The patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EN6207) via an unspecified route of administration in left arm on 22Mar2021 at 11:00 at single dose for COVID-19 immunisation. No follow-up attempts are needed. No further information is expected. Amendment: This follow-up report is being submitted to amend previously reported information: lab data added.

Other Meds:

Current Illness:

ID: 1651185
Sex: M
Age:
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: administered 0.5 ml of BNT162b2 vaccine, instead of 0.3 ml; This is a spontaneous report from a contactable healthcare professional. A 26-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0162), intramuscularly in the left arm on 08Apr2021 (at the age of 26-years-old) as a 0.5 ml single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 08Apr2021, the patient was administered 0.5 ml of BNT162b2 vaccine, instead of 0.3 ml. The event did not result in doctor or other healthcare professional office/clinic visit or emergency room/department or urgent care. No therapeutic measures were taken as a result of the event. The clinical outcome of the event was unknown. No follow-up attempts are needed. No further information is expected. Amendment: This follow-up report is being submitted to amend previously reported information: reaction data (updated event to overdose), treatment (NO), and outcome (UNKNOWN).

Other Meds:

Current Illness:

ID: 1651186
Sex: F
Age:
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Administered 0.5 mL of vaccine, not 0.3 mL; This is a spontaneous report from a contactable healthcare professional. A 30-year-old female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0162), intramuscularly in the left arm on 08Apr2021 (at the age of 30-years-old) as a 0.5 ml single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 08Apr2021, the patient was administered 0.5 ml of BNT162b2 vaccine, instead of 0.3 ml. The event did not result in doctor or other healthcare professional office/clinic visit or emergency room/department or urgent care. No therapeutic measures were taken as a result of the event. The clinical outcome of the event was unknown. No follow-up attempts are needed. No further information is expected. Amendment: This follow-up report is being submitted to amend previously reported information: reaction data (updated event to overdose), treatment (NO), and outcome (UNKNOWN).

Other Meds:

Current Illness:

ID: 1651187
Sex: F
Age:
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Administered 0.5 mL of vaccine, not 0.3 mL; This is a spontaneous report from a contactable healthcare professional. A 20-year-old female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0162), intramuscularly in the left arm on 08Apr2021 (at the age of 20-years-old) as a 0.5 ml single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 08Apr2021, the patient was administered 0.5 ml of BNT162b2 vaccine, instead of 0.3 ml. The event did not result in doctor or other healthcare professional office/clinic visit or emergency room/department or urgent care. No therapeutic measures were taken as a result of the event. The clinical outcome of the event was unknown. No follow-up attempts are needed. No further information is expected. Amendment: This follow-up report is being submitted to amend previously reported information: reaction data (updated event to overdose), treatment (NO), and outcome (UNKNOWN).

Other Meds:

Current Illness:

ID: 1651188
Sex: F
Age:
State: PA

Vax Date: 05/04/2021
Onset Date: 05/05/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Arm pain near injection site.; Body aches; Malaise; Tired; Slight brain fog; Diarrhea; stomach upset; This is a spontaneous report from a non-contactable consumer, the patient. A 30-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0170) via an unspecified route of administration in the right arm on 04May2021 at 11:30 (at the age of 30-years-old) as a single dose for COVID-19 immunisation. Medical history was not provided. The patient received unspecified medications within two weeks of vaccination. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 05May2021, the patient experienced arm pain near injection site, body aches, malaise, tired, slight brain fog, diarrhea and stomach upset. Patient didn't receive treatment for events. The adverse events didn't result in doctor or other healthcare professional office/clinic visit, or emergency room/department or urgent care. The clinical outcome of the events arm pain near injection site, body aches, malaise, tired, slight brain fog, diarrhea and stomach upset were unknown at the time of this report. No follow-up attempts are needed. No further information is expected. Amendment: This follow-up report is being submitted to amend previously reported information: added information that patient didn't receive treatment for events.

Other Meds:

Current Illness:

ID: 1651189
Sex: F
Age:
State: CA

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: Test Date: 20210421; Test Name: body temp elevated; Result Unstructured Data: Test Result:elevated; Comments: elevated; Test Date: 20210421; Test Name: heart rate elevated; Result Unstructured Data: Test Result:elevated; Comments: elevated

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: heart rate elevated; body temp elevated; can't sleep well; tired; felt hot all the time; 1st herpes outbreak in 9 months; This is a spontaneous report from a contactable consumer, the patient. This is the first of two reports. A 41-year-old non-pregnant female patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EN0171) via an unspecified route of administration in the left arm on 20Apr2021 at 12:00 (at the age of 41-year-old), as dose 2, single for COVID-19 immunisation. Medical history included chronic constipation, herpes, allergic to contrast dye, red dyes, milk products and penicillin. Concomitant medications included linaclotide (LINZESS), lysine (MANUFACTURER UNKNOWN) and linum usitatissimum seed oil (FLAX OIL), all for unknown indication from unknown date. The patient previously received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Lot Number: ER8732) via an unspecified route of administration in the left arm on 23Mar2021 at 12:00 (at the age of 41-year-old), as dose 1, single for COVID-19 immunisation and experienced constipation and bad menstrual cycle. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 21Apr2021, the patient experienced heart rate elevated, body temp elevated, could not sleep well, felt tired, felt hot all the time and experienced 1st herpes outbreak in 9 months. No therapeutic measures were taken as a result of the events. The patient underwent lab tests and procedures which included: heart rate elevated, result: elevated and body temp elevated, result: elevated on 21Apr2021. The clinical outcome of the event heart rate elevated, body temp elevated, could not sleep well, tired, hot all the time and 1st herpes outbreak in 9 months was not recovered at the time of reporting. No follow-up attempts are needed. No further information is expected.

Other Meds: LINZESS; LYSINE; FLAX OIL

Current Illness:

ID: 1651190
Sex: M
Age:
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: patient was administered 0.5 ml of BNT162b2 vaccine, instead of 0.3 ml; This is a spontaneous report from a contactable healthcare professional. A 34-year-old male patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0162), intramuscularly in the left arm on 08Apr2021 (at the age of 34-years-old) as a 0.5 ml single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 08Apr2021, the patient was administered 0.5 ml of BNT162b2 vaccine, instead of 0.3 ml. The event did not result in doctor or other healthcare professional office/clinic visit or emergency room/department or urgent care. No therapeutic measures were taken as a result of the event. The clinical outcome of the event was unknown. No follow-up attempts are needed. No further information is expected. This follow-up report is being submitted to amend previously reported information: reaction data updated event to overdose, treatment none, and outcome was UNKNOWN.

Other Meds:

Current Illness:

ID: 1651191
Sex: M
Age:
State:

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: Test Date: 20210501; Test Name: Body Temperature; Result Unstructured Data: Test Result:100 Units:[degF]; Comments: fever over 100 degrees Farenheit

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: General body pain; Chills; Headache; Nausea; fever over 100 degrees Farenheit; This is a spontaneous report from a non-contactable consumer. A male patient of unknown age received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on 30Apr2021 as a single dose for COVID-19 immunisation. Medical history was not reported. Prior to the vaccination, it was unknown whether the patient was diagnosed with COVID-19. It was unknown whether the patient received any other vaccines within four weeks prior to the vaccination. On 01May2021 the patient experienced general body aches/chills, nausea, headache and fever over 100 degrees Farenheit. The events did not result in doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. It was unknown whether the patient received any treatment for the events. Since the vaccination, the patient had not been tested for COVID-19. The clinical outcome of the event general body aches/ chills, nausea, headache and fever over 100 degrees Farenheit was recovered on an unknown date in May2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1651192
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 08/28/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Numbness in the hand after the second dose; When she lays on that side it gets worse; This is a spontaneous report from a Non-contactable nurse. This nurse (patient's son) reported for a 60-year-old female patient (reporter's mother). A 60-year-old female patient received second dose of BNT162B2 (BNT162B2, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, administered on an unspecified date as dose 2, single for COVID-19 immunization. Patient received a dose of BNT162B2 (BNT162B2, Formulation: Solution for injection, Lot Number: unknown, Expiration date: unknown), via unspecified route, administered on an unspecified date as dose 1, single for COVID-19 immunization. The patient medical history and concomitant medications were not reported. On an unspecified date 2021, after the vaccination, the patient experienced numbness in the hand and When she lays on that side, she has it gets worse, when lays on the other side it doesn't get any worse, stays the same. The events assessed as non-serious. The outcome of the events was unknown. No follow-up attempts possible. No further information expected.

Other Meds:

Current Illness:

ID: 1651193
Sex: M
Age:
State: VT

Vax Date: 04/06/2021
Onset Date: 04/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: severe dizziness; nausea; Blood pressure was unusually high during this period; Dehydrated; This is a spontaneous report from a contactable consumer, the patient. A 60-year-old male patient received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER8737) via an unspecified route of administration in the arm right on 06Apr2021 at 16:00(at the age of 60-year-old) as a single dose for COVID-19 immunisation. Medical history included Stage 3 kidney failure, obesity, idiopathic (likely gluten) peripheral neuropathy, and Raynaud's syndrome. Concomitant medications included pregabalin (LYRICA), losartan (MANUFACTURER UNKNOWN) and paracetamol (TYLENOL); all from unknown date for unspecified indication. The past drug history was reported that patient had many drugs reaction. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EN6198) via an unspecified route of administration in the arm right on 16Mar2021 at 14:15(at the age of 60-year-old) as a single dose for COVID-19 immunisation. Prior to the vaccination, it was unknown whether the patient was diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 08Apr2021 at 10:00 approximately 32 hours after the vaccination, the patient experienced severe dizziness and nausea and Blood pressure was unusually high during this period. On an unknown date in Apr2021 the patient experienced dehydrated. It was reported approximately 32 hours post vaccine severe dizziness and nausea, had to return to bed. Somewhat improved approx. 8 hours later, could carefully move about. Less severe but remained approximately 6 days. Did continue 3 more days before the patient realized he was dehydrated and that was likely reason it continued. The patient had a history of drug reactions to a great number of medications. The patient was very drug sensitive. Blood pressure was unusually high during this period. The patient did not bother the physician as he never felt anything more than inconvenience after the first day of onset. The adverse events did not result in a visit to the doctor or other healthcare professional office/clinic visit, and emergency room/department or urgent care. The patient did not receive any treatment for the events. The clinical outcome of dizziness, nausea, dehydrated and blood pressure high were resolving. No follow-up attempts are needed. No further information is expected.

Other Meds: LYRICA; LOSARTAN; TYLENOL

Current Illness:

ID: 1651194
Sex: F
Age:
State: CO

Vax Date: 04/01/2021
Onset Date: 04/18/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: 2 weeks after 1st shot - I broke out in a bright red, raised rash along my arms and torso.; 2 weeks after 1st shot - I broke out in a bright red, raised rash along my arms and torso.; This is a spontaneous report from a contactable consumer, the patient. A 39-year-old non-pregnant female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: EW0161) via an unspecified route of administration in the arm right on an unknown date in Apr2021 at 14:00 (at the age of 39-years-old) as a single dose for COVID-19 immunisation. Medical history included allergy. The patients past drug was reported as no. Concomitant medications taken within two weeks prior to the vaccination included cetirizine hydrochloride (ZYRTEC) from an unknown date for allergy and ethinylestradiol, norethisterone acetate (JUNEL) from an unknown date for birth control. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 18Apr2021 at 14:30, two weeks after first shot the patient experienced a break out in a bright red, raised rash along her arms and torso. The patient had been hiking on a sunny day - wondering if it was triggered by the heat/sun. The rash was still on-going 10 days later, although it was fading. Therapeutic measures were taken as a result of bright red, raised rash along arms and torso and included over the counter treatment with benedryl and cortisone cream from an unknown date to an unknown date. The clinical outcome of the event bright red, raised rash along arms and torso was resolving at the time of this report. The patient also received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot number: EW0179), via an unspecified route of administration in right arm on 02May2021 at 14:15 (at the age of 39-years-old) as single dose for COVID-19 immunisation and the adverse events for the second dose were not reported No follow-up attempts are needed. No further information is expected.

Other Meds: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; JUNEL

Current Illness:

ID: 1651195
Sex: F
Age: 52
State: OH

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Did not go to doctor because most of my coworkers had similar reactions.

Allergies: None known

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: shot was given in the am...around 8-9 pm started feeling achy, tired, fever, freezing...took ibuprofen, put on socks, sweatshirt and gloves because I couldn't get warm...went to bed...woke up at 2-3am drenched in sweat....took off gloves, socks, sweatshirt, went to bathroom...stood to pull up pants with right arm (still very sore from injection)...everything went dark...my husband came into the bathroom and I was laying on the floor....I couldn't stand... I had to crawl to the living room where my husband helped me into a chair...he got me cold wet towel, more ibuprofen and water....I slept most of the day...I was scheduled to work the weekend but missed all three days (F, Sa and Su)

Other Meds: None

Current Illness: None

ID: 1651196
Sex: M
Age: 92
State: NY

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 08/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Patient received pfizer covid-19 booster vaccine day prior to arrival to hospital. at that time pt experienced near syncope, weakness/fatigue, decreased appetite. pt found to have sepsis like picture with acute renal failure. also found to have likely mild UTI.

Other Meds: atorvastatin metoprolol tartrate ?tamsulosin

Current Illness: none

ID: 1651197
Sex: F
Age: 14
State: CA

Vax Date: 08/05/2021
Onset Date: 08/09/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: EKG, (abnormal) troponin (slightly elevated), and echo (normal.

Allergies: None.

Symptom List: Injection site pain, Menorrhagia

Symptoms: I saw the patient in the emergency department 4 days after she received the 2nd dose of one of the COVID vaccines. I am not sure where she got the vaccine or the manufacturer. She was diagnosed with pericarditis, and this is the reason for this report. She was seen and will be followed by a cardiologist.

Other Meds: None.

Current Illness: None.

ID: 1651198
Sex: F
Age: 37
State: MO

Vax Date: 08/24/2021
Onset Date: 08/25/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None at this time

Allergies: None

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Abnormal uterine bleeding and cramping

Other Meds: Buspirone, Zoloft, levothyroxine, Sprintec, Lansoprazole, Zyrtec

Current Illness: None

ID: 1651199
Sex: F
Age: 13
State: TN

Vax Date: 08/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: BP and BG tests normal.

Allergies: NA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient had a syncopy type reaction for about 1 minute. Right after the vaccine was given, patient stopped responding to verbal or physical cues. Her eyes were open and she was sitting upright. Her pulse was normal. About that time the emergency personnel were contacted. After about a minute or two she slowly started responding. Water was provided and she felt better after drinking some. EMS checked her BP and BG that came back normal. They asked her to go to the doctor or to sit at the pharmacy for about 20 minutes. The father decided to stay at the pharmacy for 20 minutes and she seemed normal at that point.

Other Meds: NA

Current Illness: NA

ID: 1651200
Sex: F
Age: 28
State: IN

Vax Date: 08/26/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data: None.

Allergies: None.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I received my second vaccine at 12:00 pm on August 26, 2021. Around 6:00 the muscle spasms in my feet, legs, and hands started. By 8:00 that evening, I just wasn't feeling well so I went to bed early. I woke up around midnight vomiting, total body aches, and had a 103.4 degree fever. I took Tylenol and went back to bed. I slept through the day on the 27th and struggled keeping my fever down with medicine. The fever, aches, chills, and fatigue lasted through the day and night.

Other Meds: 1. 101-103 degree fever - unable to get under 101 degrees even with medication 2. Muscle spasms in fingers, toes, and legs (this started 6 hours after vaccination) 3. Headache 4. Fatigue - I?ve slept the last 19/24 hours and still feel

Current Illness: None.

ID: 1651201
Sex: M
Age: 65
State: FL

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Had a full run of blood tests including RA and Lyme D. All came back normal except a high reading of 113 LDL and 130 HDL and finally reactive protein 10.6

Allergies: none

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Full body soreness. Legs feel extremely heavy, Left shoulder extremely painful as is my right wrist up to my elbow, Both legs and hip joints sore and painful. Lower left leg throbs and is hot. Every now and then a rush of heat from my feet to my head overcomes me. This event even impacts my jaws. Difficult sleep as I cannot adjust with out waking up in pain. Sitting then standing very difficult. I am a 190 lb. fit male. Runner, gym guy, non-smoker, light drinker and aware of what I eat. I have been working through these symptoms for 2 years, but they worsened after the shots.

Other Meds: 10 mg. 1/day:Citalopram 10mg. 1/dar: Zyrtec Aleve two or three times / week

Current Illness: None

ID: 1651202
Sex: F
Age: 37
State: NC

Vax Date: 08/23/2021
Onset Date: 08/25/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Moderate period cramping and bleeding. This is completely irregular for me. These pains are much more intense than typical camping and period is was 100% unexpected. Had just finished last period the week before. Cycle is consist and and regular other than this.

Other Meds: Norethindrone

Current Illness: None

ID: 1651203
Sex: F
Age: 43
State: OH

Vax Date: 08/23/2021
Onset Date: 08/23/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: morphine, ondansetron

Symptom List: Injection site pain

Symptoms: Patient called on call doctor for her PCP office, reporting fevers (Tmax 101.3 8/26) and vomiting since her Moderna booster dose at the Dept of Public Health on Monday 8/23. She was unable to keep liquids down so she was advised to seek emergency evaluation

Other Meds:

Current Illness:

ID: 1651204
Sex: F
Age: 67
State: KY

Vax Date: 04/01/2021
Onset Date: 08/24/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: patient was fully vaccinated with moderna as of April. Patient is symptomatic and has tested positive as of 8/24

Other Meds:

Current Illness:

ID: 1651205
Sex: F
Age: 96
State: OH

Vax Date: 01/01/2021
Onset Date: 05/01/2021
Rec V Date: 08/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: All cultures cam back negative. Pneumonia confirmed with x-ray spot on lung and fever over 100 degrees

Allergies: none

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Pneumonia of unknown origin after thorough testing within 2 week hospital stay. Patient never had history of past pneumonia.

Other Meds: asprin

Current Illness: none, very healthy all life

ID: 1651206
Sex: M
Age: 52
State: OH

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None to date. Patient has called his specialist and has an appointment scheduled.

Allergies:

Symptom List: Tremor

Symptoms: Later the day of dose 2 the patient developed a hard knot in the right upper inner arm. The know lasted several days. There was no redness, warmth or swelling. After the knot resolved the patient experiences moderate to severe pain in the right deltoid.

Other Meds:

Current Illness: none

ID: 1651207
Sex: F
Age: 67
State: GA

Vax Date: 01/23/2021
Onset Date: 02/05/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: NA

Symptom List: Erythema, Pruritus

Symptoms: I had little red itchy bumps all my body, joints, legs, arms, knees, elbows, butt, and my ears. The bumps were very itchy and irritating all over my body. I thought at it first it may of been poison ivy but it was everywhere. I saw my PCP and she prescribed me some hydrocortisone cream and I used a lot of lotion.

Other Meds: Famotidine, Multivitamin, Calcium, Vitamin D.

Current Illness: NA

ID: 1651208
Sex: M
Age: 47
State: MD

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data: Ekg 6/30/21 Blood work 7/31/21

Allergies: Amoxil

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Mycarditis, rapid heartbeat, heart racing/heavy beating in chest

Other Meds: Multivitamin, vitamin c, aleve

Current Illness: Na

ID: 1651209
Sex: F
Age: 26
State: NE

Vax Date: 08/15/2021
Onset Date: 08/22/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: One week after my first vaccine shot I took Alavert for my allergies and developed a severe fever. I had chills and could not get warm in my apartment that was 79 degrees. I was drowsy and slept and had little energy for two days. This happened again when I took Alavert on 8/27. I have taken Alavert since I was a child and never experienced these symptoms before. There have been no changes in diet or lifestyle or environment. The only change is my COVID vaccine shot. I had COVID in November 2020, so I did experience 3 days of mild side effects from the vaccine, including aches, sore arm, and fatigue.

Other Meds:

Current Illness:

ID: 1651210
Sex: F
Age: 31
State: PR

Vax Date: 08/25/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None yet

Allergies: No

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: During yesterday afternoon, when I was bathing, I felt a lump in the neck area on the left side of by body. On the same side were the vaccine was administered. When looking for data in the internet, I found that it is due to swollen lymph nodes and that it should be reported.

Other Meds: Alive Multivitamin Women

Current Illness: No

ID: 1651212
Sex: F
Age: 68
State: NJ

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: N?A

Allergies: none

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Vomiting, extreme pain in limbs, stiff neck, insomnia, fever of 100F

Other Meds: xanax, tylenol

Current Illness: none

ID: 1651213
Sex: F
Age: 18
State: AL

Vax Date: 08/27/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Patient had received 2 doses of Moderna prior, 2nd dose being some time in April. Patient is not immunocompromised and received a 3rd dose of Pfizer in error. No adverse event is apparent at this time.

Other Meds:

Current Illness:

ID: 1651214
Sex: F
Age: 41
State: TX

Vax Date: 06/17/2021
Onset Date: 07/25/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Shingles (trigeminal, V1) with local swelling and painful swollen lymphnodes. First diagnosed as cellulitis, given antibiotics (Cefalexon). Did not improve after several days. Suspected shingles when electrical sensations and itching in the area developed . Prescribed Valtrex, which resolved symptoms. Skin is still healing.

Other Meds: Ubrelvy (25mg) as needed

Current Illness: None

ID: 1651215
Sex: F
Age: 67
State: VA

Vax Date: 02/26/2021
Onset Date: 03/07/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data: Mammogram June 28th?

Allergies: Biaxin, amoxicillin, latex

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: I had a slightly enlarged lymph gland in my left breast become tender. It had become larger, and so I got a mammogram, got called back for an ultrasound. The finding was enlarged lymph not. I had gotten swollen glands following my 2nd. dose in my left armpit for a long time - as in over a month. I have no idea if this is related. I think the mammo was in June; my online records are apparently down as I write. The swollen gland is still there.

Other Meds: multi-vitamin, Calcium Citrate -630mg. and D3 500 IU, 500 mg. elderberry extract, 500 mg. Boswellia Extract, Vitamin C, 1000, mg No prescriptions, no otc meds.

Current Illness: None

ID: 1651216
Sex: F
Age: 75
State: TX

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Multiple tests were run

Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Joint pain, dizziness, falling due to dizziness, fatigue, headaches, worsening depression with suicidal ideation, lasting several weeks to more than 2 months.

Other Meds: Multiple medications for hypertension, type 2 diabetes, and depression

Current Illness: Underlying chronic medical conditions as listed above

ID: 1651217
Sex: F
Age: 37
State: UT

Vax Date: 08/01/2021
Onset Date: 08/28/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Red area on arm at injection site with distinct borders, hot to the touch. Approx 5 inches by 4 inches at time of report. Area is painful and itchy.

Other Meds: Multivitamin

Current Illness: No illness

Date Died: 08/27/2021

ID: 1651218
Sex: M
Age: 65
State: WV

Vax Date: 04/10/2021
Onset Date: 08/03/2021
Rec V Date: 08/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Left Heart Cath likely 8/4 or 8/5/21, CT of brain 8/8/21, Vascular surgery 8/25 or 8/26/21

Allergies:

Symptom List: Vomiting

Symptoms: Patient with history of diabetes and CHF came in for non-ST elevated myocardial infarction on 8/3/21 for Left Heart Cath. Another admission on 8/8/21 for stroke-like symptoms, CT scan of head revealed acute-subacute infarction. Patient had extended stay in hospital, suffering a second stroke. Then underwent vascular surgery on either 8/25/21 or 8/26/21 to remove thrombus (blood clot) in one leg. After surgery went to ICU for recovery, and was transferred to floor bed after one day. He expired (passed away) on 8/27/21.

Other Meds:

Current Illness: Diabetes and CHF.

ID: 1651219
Sex: F
Age: 44
State: IL

Vax Date: 05/01/2021
Onset Date: 05/12/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Have bot felt well for a month with migraines shooting pain in my head and eyes. Requested a PET scan due to the fact I am a cancer survivor. PET scan showes enlarged lymphnodes in neck, chest, abdomen, pelvis.

Allergies: Medications: beta blockers, all prescription bladder infection pills, 5 day antibiotic pack meds

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: First symptom was rash on both upper arms which I had both shots in left arm. Nothing helped the itching. It last for about 3 weeks

Other Meds: Verapamil, vit D, xanax, veniflaxen, lunesta

Current Illness: Migraines

ID: 1651220
Sex: F
Age: 75
State: TX

Vax Date: 02/01/2021
Onset Date: 08/16/2021
Rec V Date: 08/28/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: PCR COVID testing

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Breakthrough COVID infection

Other Meds: Multiple medications for underlying chronic conditions of hypertension, type 2 diabetes, and depression

Current Illness:

ID: 1651221
Sex: F
Age: 9
State: TX

Vax Date: 08/01/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Father presented to ER for daughter having upper respiratory/flu-like symptoms. Adds "I lied about my daughter's age so that she could receive a dose of the COVID Pfizer vaccine last week."

Other Meds: Albuterol

Current Illness:

ID: 1651222
Sex: F
Age: 51
State: NC

Vax Date: 07/31/2021
Onset Date: 08/24/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Had recent labs to include CBC which was within normal limits. Consulted primary care provider. Await appointment with gynecologist. Last Pap within past two years with normal findings.

Allergies: Ibuprofen, Amoxicillin, Metoprolol

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Originally having fatigue, body aches, chills, fever, and decrease appetite for 1-3 days after vaccine. Now having post menopausal bleeding which is heavy and with cramping and passing blood clots.

Other Meds: Protonix, Losartan, Tylenol, Tizanidine, Zyrtec, Vitamin D, Vitamin C, Zinc

Current Illness: None

ID: 1651223
Sex: F
Age: 61
State: NY

Vax Date: 08/19/2021
Onset Date: 08/27/2021
Rec V Date: 08/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Large rash on arm 8 days following vaccine

Other Meds: Synthroid, Aimovig

Current Illness: none

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am